New guidelines tell GPs that they should now offer acupuncture to their patients with chronic back pain. This is the first time an alternative therapy has been backed in this way and smacks of desperation. What worries me most is their reasoning. The guidance says anyone whose pain persists for more than six weeks should be given a choice of several treatments, because the evidence about which works best is so uncertain. Translated for you into plain English it says ‘we have no idea so might as well try them all and hope one works.’ And this is supposed to have come from the National Institute of Clinical Excellence. Makes you think.
Results showing the ineffectiveness of most alternative remedies continue to pour out and so, in what I have to admit is a quite brilliant move, the peddlers of this snake oil have had a change of semantics. Instead of ‘alternative’ the treatments are now known as ‘complimentary’ i.e. they are now supposed to be used alongside traditional medical treatments. If that doesn’t sound like an admission of their uselessness I don’t know what is. (If I sound a little closed to other ways of treating illness then forgive me. I am not. What I am utterly opposed to is the dressing up of unsubstantiated mumbo jumbo witchery as science, coupled with a very selective reading of the ‘evidence’.
The truth is that back pain is difficult to treat and rarely has an easily identifiable cause. It one on a list of many heart-sink complaints that GPs dread hearing, like ‘I’m tired all the time, doctor’ or ‘I don’t feel right in myself.’ For many doctors this decision will come as mana from heaven -finally something to help get the patients out of the consulting room door on time AND they feel like we have actually been helpful. Doctor happy, patient happy, but commonsense, logic and 200 years of medical science have just been shat upon. Trials looking at the efficacy of acupuncture have shown that it helps a bit, for some people, but so does sham acupuncture (sticking needles anywhere) and so does jabbing the skin with toothpicks. And come to think of it so does a cup of green tea, a good chat with a friendly looking therapist and a back rub. And perhaps that is the key: time and a sympathetic ear, certainly lacking from many GP consultations today. If time and money were spent on improving access to GPs and the amount of time they can spend with their patients I’m certain that many chronic conditions would improve, without the need to fool and insult patients with sham quackery.
Hi there Christian,
ReplyDeleteI can only imagine what it must be like for doctors in a GP surgery situation where a patient presents themselves with sometimes what may be fairly serious problems in their/ GP’s eyes and there be a multitude of possible solutions.
Drawing on from your above post on prescribing of pills for things like back pain to even depression, I think I would find a situation where you have someone in-front of you telling you that they want to end it all and can’t see any way forward without some sort of pill, very difficult. I’m all for natural coping strategies non- chemical (drugs) and would not want to move someone onto taking a form of drug.
I’ve heard of people getting drugs quickly for things like ‘depression’ and then still taking further attempts to overdose on other drugs poss for attention or whatever – but obviously still being destructive of their bodies regardless.
Isn’t it in everyone’s best interests when dealing with something like this to try and help facilitate empowerment of such an individual and help them develop a sense of control over their lives (as much as anyone can over their lives given that anything can happen in life of-course to a certain extent) particularly at a point where they don’t seem to have any... rather than offer them an external method (drugs going into their system) to heal something that is far deeper than any drug may ever really reach and thus, directing them on a path farther away from where they really need to be (at one with oneself in their own skin) free from external blocks/ distractions that keep them from being the real them?
Obviously GPs have responsibilities I know that...
I’m not sure – is it not within a GPs remit to try using other methods - as you mentioned, such as simply listening and helping to discuss natural coping strategies to help improve? If not why should it not be within GP jurisdiction to carry the aforementioned out? If it’s not I think it’s time to start.